Margie describes a study suggesting that kids who use dummies (pacifiers)
had lower IQ scores or problems with intellect.  There were no refs
attached, so we can't really credit it, but I will add a hypothetical
comment.  If the observation is valid, reverse causality again could be
involved.  What if children who are attracted to pacifiers have subtle brain
disorders or weaknesses that make pacifiers either necessary or somehow
useful to them?

I've discussed before the fact (with refs. galore from the Japanese ENT
lit -- see archives) that there appears to be an association both with
excessive thumb sucking and pacifier use and breathing disorders/apnea.
These children appear to be using non-nutritive suck as a way to maintain
patent airways and to control their respiratory function via a secondary
pathway because the primary cerebral control center for breathing is
depressed.  This appears to be the mechanism that Fleming identified in his
study (see archives) that observed an increase in SIDS AFTER pacifier use
was discontinued.  Those babies were relying upon the pacifiers to prevent
apnea.

So it follows from that literature that these may be babies with something
amiss.  Therefore, do we blame the pacifier, or should we look more closely
at the baby?  I refer people to the nice article by Maria Ramsey (Ramsey,M
and Gisel,E:  Neonatal Sucking and Maternal Feeding Practices, Dev Med and
Child Neurol 1996, 38:34-47.) This article describes feeding problems as the
earliest sign of neurological dysfunction.

This discussion relates back to the 'nipple confusion' dialog we've all been
engaged in.  Is the preference for pacifiers/bottles and the inability to
breastfeed (either prior or following bottle teat exposure) a marker for a
baby (rather than a teat ) problem?  I think it is.  Does this mean we go
into long, alarming explanations:  No.  I think we just do the best we can
to get the breastfeeding going, because it is obviously most impt. for these
babies to have the benefits and protections of milk.  Luckily, many
neurological problems appear to be transient.

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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